The detection of two cases of the disease by the marburg virus (EVM) in Ghana, the first in the country, turned on the alerts. The reason: it is a hemorrhagic fever almost as deadly as Ebola, and without a vaccine.
The World Health Organization (WHO) warns that EVM “It’s serious and often deadly.” Its incubation period is between two and 21 days.
Symptoms
The WHO points out that the symptoms of this disease appear suddenly, with a high fever, an intense headache and great discomfort, as well as frequent muscle aches.
On the third day, explains the body, intense watery diarrhea, abdominal pain and cramps, nausea and vomiting may appear. Diarrhea may persist for a week. Eyes sunken, patients suffer from extreme lethargy and present what the OMS described as “ghost-like”.
Between days five and seven, patients usually have severe bleeding. Fatal cases usually present some form of hemorrhage, often in multiple organs. The presence of fresh blood in vomit and feces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venipuncture sites where fluids are given or blood samples are drawn can be especially troublesome. During the severe phase of the disease, patients have a persistently high fever.
This disease affects the central nervous system: patients present confusion, irritability and aggressiveness. In the late phase of the disease (15 days after onset), orchitis (inflammation of the testicles) may occur in men.
Death usually occurs within eight to nine days of the onset of symptoms. “It is usually preceded by large blood loss and shock,” says the OMS.
Mortality
The average fatality rate of the disease, warns the WHO, is around 50%. However, it can be as high as 88%, depending on the viral strain and care.
The OMS stresses that rehydration and rapid administration of symptomatic treatment improve survival.
Origen
It is considered that the natural host of marburg virus is the fruit bat (Rousettus aegyptiacus, family Pteropodidae). The virus is transmitted from these bats to humans and spreads between them directly.
The EVM it was identified for the first time in 1967 after simultaneous outbreaks in Marburg and Frankfurt (both cities in Germany) and in Belgrade (Serbia).
Although marburg virus and Ebola are different viruses, both belong to the Filoviridae family and cause diseases with similar clinical characteristics, says the WHO.
The 1967 outbreaks were associated with laboratory work on African green monkeys (Cercopithecus aethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases have been reported in Angola, Kenya, the Democratic Republic of the Congo, South Africa (in a person who had recently traveled to Zimbabwe), and Uganda.
In 2008, two separate cases were reported in travelers who had visited a cave inhabited by colonies of Rousettus bats, Uganda.
Transmission
It is transmitted by direct contact of broken skin or mucous membranes with blood, secretions, organs, or other bodily fluids of infected persons, as well as with surfaces and materials contaminated with such fluids, such as personal or bedding clothing.
The WHO points out that cases of transmission to health personnel caring for patients with EVM suspected or confirmed, “through close contact without proper infection control precautions. Infection through contaminated injection equipment or needle sticks is associated with greater severity of illness, faster worsening, and possibly a higher case fatality rate.”
Like Ebola, the Marburg virus can also be spread at funeral ceremonies where mourners have direct contact with the body of the deceased.
The patient can spread the disease as long as he has the virus in his blood.
Treatment
According to the WHO, no treatment has been shown to be effective in neutralizing this virus, but various immunological, pharmacological and blood-derived treatments are being developed.
Neither does there exist, up to now, a vaccine against EVM.
Supportive therapy with oral or intravenous rehydration and treatment of certain symptoms improve the chances of survival. The WHO indicates that in some cases the use of “monoclonal antibodies in development and certain antivirals that have been used in clinical studies to treat Ebola, such as remdesivir and Favipiravir,” could be tested.
It details that “in May 2020, the European Medicines Agency granted a marketing authorization for the Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo) vaccines against EVM. The latter contains a virus called Vaccinia Ankara Bavarian Nordic that has been modified to express proteins from the Ebola-Zaire virus and three other viruses from the same group (family Filoviridae). Although this vaccine could protect against MVD, its efficacy has not yet been demonstrated in clinical trials.”
How can it be diagnosed?
Since the symptoms of EVM resemble those of malaria, typhoid fever, shigellosis, meningitis and other viral hemorrhagic fevers, the best to confirm if it is the marburg virus is to use the following methods:
enzyme-linked immunosorbent assay (ELISA);
antigen detection tests;
serum neutralization test;
reverse transcriptase-polymerase chain reaction (RT-PCR);
electron microscopy; Y
virus isolation in cell culture
Read also: Concern over the first outbreak in Ghana of the Marburg virus, from the same family as Ebola
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